Arthritis and musculoskeletal conditions publications

Chronic back problems are common conditions in Australia (16% of the total population) and cause of disability (28% of the total population with disability) in Australia. Chronic back problems can have a strong negative effect on a person’s quality of life, affecting their ability to participate in daily activities, work, family and social activities. This bulletin provides the latest detailed information on the impacts (in terms of quality of life and disability) of chronic back problems in Australia.

Musculoskeletal conditions are responsible for a substantial proportion of the non-fatal burden of disease in Australia. This bulletin describes the contribution of musculoskeletal conditions to mortality. Although musculoskeletal conditions were not among the leading underlying causes of death, this bulletin shows that these conditions were likely to have contributed to about 1 in 20 deaths in Australia in 2013.

This working paper uses the Australian Institute of Health and Welfare’s recently developed assessment framework to assess the suitability of the Australian Rheumatology Association Database as a potential new data source for population health monitoring of inflammatory arthritis.

This report presents information about the prevalence and impact of osteoporosis in Australians aged 50 and over. A broad range of data sources show that osteoporosis prevalence markedly increases with age and is more common in women than in men. Osteoporosis is one of several risk factors for minimal trauma fracture, with minimal trauma fracture of the hip being one of the most serious possible outcomes of osteoporosis. Although the rate of minimal trauma hip fracture for people aged 50 and over has decreased over the last ten years, the number of hip fractures continues to increase due to the increasing number of older adults in Australia.

Arthritis and other musculoskeletal conditions are substantial contributors to health-care expenditure in Australia. In 2008–09, estimated health-care expenditure allocated to these conditions totalled $5,690 million– the 4th most expensive disease group, accounting for 8.7% of total health-care expenditure allocated to disease groups.This report is the latest in a series on arthritis and other musculoskeletal conditions expenditure. The key objectives of this report are to describe the distribution of health-care expenditure by health-care sector for the major musculoskeletal conditions: osteoarthritis, rheumatoid arthritis, back problems and osteoporosis.

This report assesses the potential for existing data sources to improve our understanding of arthritis and other musculoskeletal conditions and highlights future opportunities for improving data for monitoring these conditions. A 4-step process is used to assess the utility of different data sources to provide relevant information on the 6 priority information areas required for monitoring these conditions. This methodological approach may also be useful for monitoring a range of other health conditions.

Arthritis and other musculoskeletal conditions affect an estimated 6.1 million Australians (approximately 28% of the total population) across all ages. Due to their diverse nature, there is considerable variation in the prevalence, treatment and management, and quality of life of people with these conditions across various life stages. This report describes these impacts in the following age groups: childhood (0–15), young adulthood (16–34), middle years (35–64), older Australians (65–79) and Australians aged 80 or over.

Rheumatoid arthritis is the most severe form of arthritis, affecting around 2% of Australians. Even though management of the condition has improved markedly in recent years, largely because of the availability of new medicines, people with rheumatoid arthritis are more likely than those without the condition to report severe pain, poor health status and psychological distress. The size of indirect costs associated with rheumatoid arthritis, such as productivity losses and the cost for carers, are currently unknown.

This snapshot brings together the latest information on juvenile arthritis, a relatively uncommon condition affecting less than 1% of Australian children. Limited national statistics make it difficult to evaluate the full extent of the effects of this condition on the children and those who care for them. However, available data show that Australian Government subsidies for new classes of treatment medications have continually increased since their introduction in 2002-03 and hospitalisation rates for girls with juvenile arthritis have increased in the 10 years to 2009-10. The reasons for this latter increase are not yet clear.

There is no cure for osteoporosis but antiresorptive drugs can reduce further bone loss and slow down disease progression. This report provide information on both the individual and community use of antiresorptive drugs for managing osteoporosis as well as trends in the supply of and expenditure for these medications.

This report presents differences in health-care use for osteoarthritis, rheumatoid arthritis and osteoporosis between population groups. The report suggests that, among those with osteoarthritis or osteoporosis, females are more likely to take actions to manage their condition and have a lower rate of joint replacement than males. The report also suggests that complimentary medicines that may slow the progression of these conditions are used at a lower rate in the lowest socioeconomic group compared to the highest socioeconomic group.

Disease and modifying anti-rheumatic drugs (DMARDs) are now considered first-line treatment for rheumatoid arthritis (RA). When initiated early, they have been shown to alter the disease course and reduce joint erosion, reducing or preventing disability and improving quality of life.

There is considerable variation in the type and extent of health services used and actions taken to manage the three conditions. While the management of osteoarthritis and rheumatoid arthritis is primarily focused on reducing pain and slowing down disease progression, the focus in the case of osteoporosis is largely on containing its role as a risk factor for fractures and other associated complications.

The disability and chronic pain due to many musculoskeletal conditions may underlie the development or exacerbation of a variety of mental disorders. The report maps the extent of their relationship in the Australian population.

Family members provide significant assistance to people with disability associated with arthritis and osteoporosis, to help them cope with their restrictions and continue independent living.The demand of caring can also have a significant impact on the health and wellbeing of carers themselves. Primary carers of people with arthritis and osteoporosis brings together data to describe the role of caring. The information provided in this report should be useful to the broader community, policy makers and anyone with an interest in carers and caring issues.

Medicines are central to managing arthritis and osteoporosis, to improve musculoskeletal functions, slow disease progression and reduce pain and inflammation. Pharmaceutical innovations over the last several years have improved the efficacy and diversity of medicines available to manage these conditions. However, the adoption of new and more effective drugs is often costly. This report provides information on what medicines Australians areusing to manage their musculoskeletal problems, how much do these medicines cost them and trends in the prescription of newer medicines.

Arthritis and musculoskeletal conditions affect more than 6 million Australians. In 2004-05, direct health expenditure on these conditions amounted to $4.0 billion or 7.5% of total allocated health expenditure in Australia. Osteoarthritis alone accounted for nearly one-third of the expenditure, mostly due to hospital costs associated with knee and hip replacements. Other major sources of expenditure included prescription pharmaceuticals for osteoporosis and rheumatoid arthritis. This report provides detailed information on health expenditure on these diseases and conditions using estimates derived from the AIHW Disease expenditure database, supported by information from various other data sources.

Rheumatoid arthritis is an often serious joint disease that affects around 400,000 Australians and is the second most common type of arthritis, after osteoarthritis. The disease is more common among females and in older age groups. The underlying cause of rheumatoid arthritis is not well understood but genetic factors play a key role (smoking also increases the risk of developing the disease). The disease reduces a person's capacity to work, with only 31% of those affected in fulltime employment in 2004-05 compared with 53% of the general population. This report provides information on other symptoms, effects and treatments, as well as looking at prevention.

Arthritis and osteoporosis are among the world's leading causes of pain and disability, and impose a substantial burden on the Australian community. These highly prevalent conditions are major reasons for the use of health and allied health services, community assistance programs, and formal and informal care. Under the National Health Priority Area of arthritis and musculoskeletal conditions, national action is focused on osteoarthritis, rheumatoid arthritis, juvenile arthritis and osteoporosis. This report brings together data and information from a wide variety of sources to provide a picture of arthritis and ostoeporosis in Australia, and highlight some of the main issues relating to these conditions. The report should be useful to policy makers, the broader community, and anyone with an interest in arthritis and osteoporosis.